HomeMy WebLinkAboutGrattan, Timothy (2) t
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ELIZABETH A.NEVILLE * ; Town Hall,53095 Main Road
TOWN CLERK o - P.O. Box 1179
ti Southold,New York 11971
REGISTRAR OF VITAL STATISTICS � � �
MARRIAGE OFFICER eFax(631) 765-6145
RECORDS MANAGEMENT OFFICER411
`�y�Q! �aWit° Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER ��'. southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISPOSAL PERMIT
CONSTRUCTION OR ALTERATION PERMIT
SEPTIC TANK or CESSPOOL
Permit No. 3231 R Residential x Non-Residential
Fee $ 10.00 Septic x Cesspool
PERMIT ISSUED TO:
Name : TIMOTHY GRATTAN
Address 1: PO BOX 622
City St Zip GREENPORT NY 11944
Descripton of Proposed Construction or Alteration
SANITARY SYSTEM FOR ONE FAMILY DWELLING.
APPROVED AS SUBMITTED AND AS APPROVED BY THE SUFFOLK COUNTY DEPARTMENT
OF HEALTH SERVICES. REF #R10-04-0077
Name Of Owner GRATTAN, SALLY
Mailing Address 1 323 CHAMPLAIN PLACE
City St Zip GREENPORT NY 11944
Property Address 1 69305 COUNTY ROAD 48
City St Zip GREENPORT NY 11944
Tax Map No. section 35.00 block 1 lot 7.000
Cross Street SOUND ROAD
Building Permit Number Cross Reference:
Issue Date: 10/01/04 Elizabeth A. Neville
Southold Town Clerk
(TOWN SEAL)
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ELIZABETH A. NEVILLE ���, yd:
ELIZABETH A.NEVILLE ,/s#
Town Hall,53095 Main Road
TOWN CLERK d ; P.O.Box 1179
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REGISTRAR OF VITAL STATISTICS Southold,New York 11971
MARRIAGE OFFICER ?i4
44 �� Fax(631) 765-6145
RECORDS MANAGEMENT OFFICER IF/ Telephone(631) 765-1800
FREEDOM OF INFORMATION OFFICER : 1 iNg � I southoldtown.northfork.net
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SOUTHOLD WASTEWATER DISTRICT
APPLICATION
CONSTRUCTION or ALTERATION PERMIT
CESSPOOL or SEPTIC TANK
Residential @$10 p( or Non-Residential @$25 Application No. 73
✓✓✓✓ ���\ Permit No.
Applicant Name /l/40 b y
Applicant Mailing Address /" d a je' 6 2,2 62L2.,v�'d•(-,- //c4scci
Septic Tank or Cesspool
Brief Description of Proposed Construction or Alteration
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Location of Proposed Construction/Alteration:
Owner of Property: �q�� G .z—7)0J
Owner Mailing Address: .123 GNAA-1,rZ,i
44— /19'4"/
Owner Property Address: kSIVET313;46rizt------ 10fcRTflAi 3f)5 -etc
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Name and phone number of contact person 4'7 7-,N43
Tax Map No:)dur) Section 3 Block D/ Lot 07
Cross Street ( )VA)v4 X 0,
NOTE: LOCATION MAP MUST BE SUBMITTED WITH APPLICATION. NEW
CONSTRUCTION REQUIRES SURVEY WITH HEALTH DEPARTMENT APPROVAL
`'/ G�
S.y ature o Applicant Date
Received by:
j
N STREET ADDRESS:69035 MAIN•ROAD
_I SURVEY OF PROPERTY
La°i 0. o A T GREENPORT
9��o �° �, TOWN OF SOUTHOLD
�•� a� �1- SUFFOLK COUNTY, N. Y.
o�E o N 1000-35-01-07
641.2 0 0 5•£ os - SCALE: 1'=30'
t'� MARCH 22, 2004
Zht z, MAY 7, 2004 (8 0.H.)
e► �Z MAY 8, 2004 (Revisions)'
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3t // IAM FAMILIAR WITH THE STANDARDS FOR APPROVAL
AND CONSTRUCTION OF SUBSURFACE SEWAGE DISPOSAL
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LA - el 19.5 SYSTEMS FOR SINGLE FAMILY RESIDENCES AND WILL
o, 0,* ABIDE BY THE CONDITIONS SET FORTH THERE/NAND
TEST HOLE e� 9 3.230k+ ON THE PERMIT TO CONSTRUCT.
4/)2/O�. Z S6 555
e 1 20.3 0 < e,,s�'`� NN. A o SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
DARK MOWN P -i t.P•
- --- - - 0.5' LOAN at �cc‘�Q �) 2?,o a• I04-
8 00 PERMIT FOR APPROVAL OF CONSTRUCTION FOR A
BROWN SANDY CLAY Zc� Pt el t0� VI SINGLE FAMILY RESIDENCE ONLY
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a - t� fto• o�j a �� �� DATE�-�R-d�- HS REF.NO. lel r d�7 7
' p t5 - C3 be r - d APPROVED -.111111% i Si_ ���/
trlx 4 i
O ''' `� n y� �� FOR 1t AXI IJNi OF I-�- a DR MS
BROWN FINE To COARSE -- .Z
SAND WITH iox SRAM V ,v@ kJ 01 '9d EXPIRES THREE YEARS FROM DATE OF APPROVAL
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PLEASE NOTE
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Q Sanitary System not to be insta8ed o r=
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use. f s underdrivewa or�� N r-
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(JI ter,
e1.3,5 _ — 16.8' \ 1, a2 to. "A) s �C �•[.Ms ?' O 7+ CI
WATER Iv BROWN FWt TO COARSE 8, es 25) 04 + ..
l7' SAND WITH/07r; QRAV$L SIN ' F T'
e� •4• $i. ELEVATIONS ARE REFERENCED TO * `', * '
s'•� .- ,30"W riAD et ASSUMED DATUM. „�
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9
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514 3 N R r to 5f•) I6' EXISTING DWELLING TO BE REMOVE,' f , " '
w gAI t� via- ate EXISTING CESSPOOL TO BE FILLED 01.4".. �y1i •
s7816 00 W rib' s (pcbl,6 IN OR REMOVED. .� % tl'�_.
8520 t„9 ..� Ce:�ti N. Y.S. LIC. NO. 49618
0' etgvie)I ANY AL TERA TION OR ADPI TION. TO THIS SURVEY IS A VIOLA TION 'ECONI C S ". EYORS, P.C. •
•-MONUMENT - OF SECTION 72090E THE NEW YORK STATE EDUCATION LAW. (631) 765-5020 FAX (631) 765-1797
EXCEPT AS PER SECTION 7209—SUBDIVISION 2. ALL CERTIFlCAT7ONS P.O. BOX 909
HEREON ARE VALID FOR THIS=MAP AND COPIES THEREOF ONLY IF
AREA=15,760 SQ. FT. SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 1230 TRAVELER STREET 04-131
WHOSE SIGNATURE APPEARS HEREON. SOUTHOLD, N. Y. 11971
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